Risk factors for air embolism following computed tomography-guided percutaneous transthoracic needle biopsy: a systematic review and meta-analysis

To quantitatively analyze the risk factors for air embolism following computed tomography (CT)-guided percutaneous transthoracic needle biopsy (PTNB) and qualitatively review their characteristics.The databases of PubMed, Embase, Web of Science, Wanfang Data, VIP information, and China National Knowledge Infrastructure were searched on January 4, 2021, for studies reporting the occurrence of air embolisms following CT-guided PTNB. After study selection, data extraction, and quality assessment, the characteristics of the included cases were qualitatively and quantitatively analyzed.A total of 154 cases of air embolism following CT-guided PTNB were reported. The reported incidence was 0.06% to 4.80%, and 35 (22.73%) patients were asymptomatic. An unconscious or unresponsive state was the most common symptom (29.87%). Air was most commonly found in the left ventricle (44.81%), and 104 (67.53%) patients recovered without sequelae. Air location (P < 0.001), emphysema (P = 0.061), and cough (P = 0.076) were associated with clinical symptoms. Air location (P = 0.015) and symptoms (P < 0.001) were significantly associated with prognosis. Lesion location [odds ratio (OR): 1.85, P = 0.017], lesion subtype (OR: 3.78, P = 0.01), pneumothorax (OR: 2.16, P = 0.003), hemorrhage (OR: 3.20, P < 0.001), and lesions located above the left atrium (OR: 4.35, P = 0.042) were significant risk factors for air embolism.Based on the current evidence, a subsolid lesion, being located in the lower lobe, the presence of pneumothorax or hemorrhage, and lesions located above the left atrium were significant risk factors for air embolism

CT radiomics model combined with clinical and radiographic features for discriminating peripheral small cell lung cancer from peripheral lung adenocarcinoma

PurposeExploring a non-invasive method to accurately differentiate peripheral small cell lung cancer (PSCLC) and peripheral lung adenocarcinoma (PADC) could improve clinical decision-making and prognosis.MethodsThis retrospective study reviewed the clinicopathological and imaging data of lung cancer patients between October 2017 and March 2022. A total of 240 patients were enrolled in this study, including 80 cases diagnosed with PSCLC and 160 with PADC. All patients were randomized in a seven-to-three ratio into the training and validation datasets (170 vs. 70, respectively). The least absolute shrinkage and selection operator regression was employed to generate radiomics features and univariate analysis, followed by multivariate logistic regression to select significant clinical and radiographic factors to generate four models: clinical, radiomics, clinical-radiographic, and clinical-radiographic-radiomics (comprehensive). The Delong test was to compare areas under the receiver operating characteristic curves (AUCs) in the models.ResultsFive clinical-radiographic features and twenty-three selected radiomics features differed significantly in the identification of PSCLC and PADC. The clinical, radiomics, clinical-radiographic and comprehensive models demonstrated AUCs of 0.8960, 0.8356, 0.9396, and 0.9671 in the validation set, with the comprehensive model having better discernment than the clinical model (P=0.036), the radiomics model (P=0.006) and the clinical–radiographic model (P=0.049).ConclusionsThe proposed model combining clinical data, radiographic characteristics and radiomics features could accurately distinguish PSCLC from PADC, thus providing a potential non-invasive method to help clinicians improve treatment decisions

Target tracking using video surveillance for enabling machine vision services at the edge of marine transportation systems based on microwave remote sensing

Abstract Automatic target tracking in emerging remote sensing video-generating tools based on microwave imaging technology and radars has been investigated in this paper. A moving target tracking system is proposed to be low complexity and fast for implementation through edge nodes in a mini-satellite or drone network enabling machine intelligence into large-scale vision systems, in particular, for marine transportation systems. The system uses a group of image processing tools for video pre-processing, and Kalman filtering to do the main task. For testing the system performance, two measures of accuracy and false alarms probability are computed for real vision data. Two types of scenes are analyzed including the scene with single target, and the scene with multiple targets that is more complicated for automatic target detection and tracking systems. The proposed system has achieved a high performance in our tests

Comparison of partial splenic embolization in HIV infected and non-HIV infected patients with cirrhosis

Objective: The aim of this study is to see whether it is effective for human immunodeficiency virus (HIV) infected patients conducted partial splenic embolization (PSE) and if there are differences in the effects of PSE between HIV and non-HIV patients. Method: We retrospectively reviewed seven patients, three were HIV infected, the rest weren't. We compared the effects of PSE between the two groups using indices of hematologic indices and liver function. Result: In HIV infected patients, WBC rose in all PSE procedure, RBC rose in 3 procedures. PLT increased in 2 procedures. ALT decreased in all patients, but the changes of ALB and AST were not obvious. In non-HIV infected patients, all the hematologic indices were increased, except one patient. ALT and AST were increased, the change of ALB was not obvious. Conclusion: PSE do improve the hematologic indices and liver function in patients with HIV and hepatitis virus co-infected, but when compare with non-HIV infected patients included in our study, we haven't seen much differences in the effects

Radiological features of AIDS complicated by pulmonary cryptococcosis: Literature review and a report of 10 cases

Purpose: To retrospectively analyze the clinical data and radiological features of AIDS complicated by pulmonary cryptococcosis (PC) for more knowledge about the condition and its diagnosis. Methods: A toal of 10 cases with AIDS complicated by pulmonary cryptococcosis was recruited as the subject of the study, and all the clinical and radiological data were collected. The patients included 6 males and 4 females, aged 40–58 years. The CD4+ T cell count was below 100/μl in 8 cases. All of them were pathologically or etiologically diagnosed with AIDS complicated by PC, and received digital radiography (DR) and CT examination. All the radiological images were retrospectively analyzed by two senior radiologists who knew nothing about the patients. Results: The radiological findings were categorized into 3 types: (1) multiple miliary nodules in 2 cases (20%), which distributed in bilateral lung apex and dorsal segment of lower lobe, being 2–3 mm∼2 cm in diameter, with “halo sign” around the larger lesion; (2) singular nodule or mass in 3 cases (30%), which was located in the peripheral region of lung, also with “halo sign” around the lesion; (3) cavity in 5 cases (50%), which was singular or multiple, with uneven thickness of the cavity wall and inner-wall nodule. In a few cases, enlarged mediastinal lymph node and pleural effusion accompanied. Conclusion: The radiological signs featured AIDS complicated by pulmonary cryptococcosis such as singular or multiple nodules with cavity and “halo sign” can facilitate its diagnosis. But the diagnosis should be made in combination to the clinical history

Two-year topographic and densitometric outcomes of accelerated (45 mW/cm2) transepithelial corneal cross-linking for keratoconus: a case-control study

Abstract Background Conventional corneal cross-linking is effective for retarding the progression of keratoconus. However the long-term efficacy and safety of accelerated (45 mW/cm2) transepithelial corneal cross-linking (ATE-CXL) on progressive keratoconus (KC) treatment is not fully understood. The purpose of this study is to evaluate the 2-year changes in corneal topographic parameters and densitometry values after ATE-CXL for KC. Methods Twenty-five progressive eyes of 25 KC patients (KC group) and 25 eyes of 25 myopes without KC (control group) were enrolled. Corneal topography and densitometry values were evaluated pre-operatively and at 6, 12 and 24 months post-operatively in the KC group. Results The mean values of flat keratometry (K1), steep keratometry (K2), mean keratometry (Km), corneal astigmatism (CA), maximum keratometry (Kmax), central corneal thickness (CCT), thinnest corneal thickness (TCT), anterior corneal elevation (ACE) and posterior corneal elevation (PCE) all remained unchanged over time (all P values > 0.05). The densitometry values of the anterior, central, posterior and total layers over the annular diameters 0 mm to 2 mm (Φ0-2 mm) and Φ2–6 mm all decreased significantly (all P values  0.05). Subgroups with Km ≥ 50.30D or ACE ≥35.3 μm progressed significantly when compared with those with Km < 50.30D (F = 8.167, P = 0.004) or ACE< 35.3 μm (F = 5.207, P = 0.022). Conclusions K1, K2, Km, CA, Kmax, CCT, TCT, ACE, and PCE values may remain stable but severer KC patients tend to have poorer long-term outcomes. The densitometry values of the full corneal thickness (total layer over Φ0-2 mm and Φ2–6 mm) may decrease to normal levels at 2 years after ATE-CXL for KC

A Predictive Model for the Risk of Posterior Circulation Stroke in Patients with Intracranial Atherosclerosis Based on High Resolution MRI

Intracranial vertebrobasilar atherosclerosis is the main cause of posterior circulation ischemic stroke. We aimed to construct a predictive model for the risk of posterior circulation ischemic stroke in patients with posterior circulation atherosclerosis based on high-resolution MRI (HR-MRI). A total of 208 consecutive patients with posterior circulation atherosclerosis confirmed by HR-MRI, from January 2020 to July 2021, were retrospectively assessed. They were assigned to the posterior circulation stroke (59 patients) and non-posterior circulation stroke group (149 patients) based on clinical presentation and diffusion-weighted imaging (DWI). Demographic data, risk factors of atherosclerosis, laboratory findings, and imaging characteristics were extracted from electronic health records. Plaque features were investigated by HR-MRI. Fifty-three clinical or imaging features were used to derive the model. Multivariable logistic regression analysis was employed to construct the prediction model. The nomogram was evaluated for calibration, differentiation, and clinical usefulness. Plaque enhancement, plaque irregular surface morphology, artery location of plaque, and dorsal quadrant of plaque location were significant predictors for posterior circulation stroke in patients with intracranial atherosclerosis. Subsequently, these variables were selected to establish a nomogram. The model showed good distinction (C-index 0.830, 95% CI 0.766-0.895). The calibration curve also showed excellent consistency between the prediction of the nomogram and the observed curve. Decision curve analysis further demonstrated that the nomogram conferred significantly high clinical net benefit. The nomogram calculated from plaque characteristics in HR-MRI may accurately predict the posterior circulation stroke occurrence and be of great help for stratification of stroke decision making

Restrictive Use of Empirical Antibiotics Is Associated with Improved Short Term Outcomes in Very Low Birth Weight Infants: A Single Center, Retrospective Cohort Study from China

Antibiotics are essential for treating neonatal sepsis, but abuse or inappropriate use of antibiotics have harmful adverse effects. The inappropriate use of antibiotics has led to the significant increase in bacterial antimicrobial resistance in the neonatal intensive care unit (NICU). The aim of this study was to retrospectively analyze the changes in antibiotic usages in a NICU after the implementation of an antibiotic stewardship program and to determine the impact of this implementation on the short-term clinical outcomes of very low birth weight (VLBW) infants. The antibiotic stewardship program was initiated in the NICU in early 2015. For analysis, all eligible VLBW infants born from 1 January 2014 to 31 December 2016 were enrolled, and we classified the year 2014 as pre-stewardship, 2015 as during stewardship, and 2016 as post-stewardship. A total of 249 VLBW infants, including 96 cases in the 2014 group, 77 cases in the 2015 group, and 76 cases in the 2016 group, were included for final analysis. Empirical antibiotics were used in over 90% of VLBW infants in all three groups during their NICU stay. Over the 3-year period, the duration of an initial antibiotic course was significantly reduced. The proportion of patients receiving an initial antibiotic course for ≤3 days gradually increased (2.1% vs. 9.1% vs. 38.2%, p 7 days significantly decreased (95.8% vs. 79.2% vs. 39.5%, p p p = 0.006). To assess the continuity of antibiotic stewardship in the NICU, data from 2021 were also analyzed and compared to 2016. The median duration of an initial antibiotic course further decreased from 5.0 days in 2016 to 4.0 days in 2021 (p p = 0.022). Total antibiotic usage days during the entire NICU stay also decreased from 10.0 days in 2016 to 7.0 days in 2021 (p = 0.010). The finding of this study strongly suggests that restricting antibiotic use in VLBW infants is beneficial and can be achieved safely and effectively in China